Doctors, pharmacists disagree on consultancy cadre approval for health workers

*PSN hails Senate for budgeting extra N57.15bn for Basic Healthcare Provision Fund
*ACPN demands immediate action on open drug markets, distribution system
There appears to be no end in sight to the recent imbroglio between doctors and pharmacists in Nigeria.Pharmacists under the aegis of Pharmaceutical Association of Nigeria (PSN) Lagos branch have condemned the doctors’ that is the Nigerian Medical Association (NMA) position on the recent Lagos State government circular on consultant pharmacist cadre and demands by striking health workers on relativity of salaries.

Health workers under the aegis of the Joint Health Sector Union (JOHESU) have been on industrial action since April 18, 2018 following inability of the Federal Government to meet their demands, which include approval of consultancy cadre for other health personnel besides medical doctors and making their salaries relative to that of the physicians.

But the NMA has kicked against these demands by the PSN and JOHESU. PSN Lagos chapter in a statement signed by the Chairman, Mrs. Bolanle Adeniran and Secretary, Babayemi Otekunle, said: “The attention of the PSN (Lagos State Branch) has been drawn to another round of tirade launched against its members and other health workers through a Press Release of 17th May, 2018 by the NMA, Lagos State Branch..

“Ordinarily, we would have ignored the mischievous presentation of these ill-informed people parading themselves as professionals who are renowned for meddlesomeness in every attempt for healthcare delivery service in Nigeria to take its pride of place as it is all over the world.

“We owe it a duty to appropriately inform the generality of Nigerians as well as the upcoming professional in the health sector in particular pharmacy to acquaint them with the true global perspectives in the matters being addressed.

“The NMA has decided to stand logic on its head by the display of emotive sensationalism by deploying falsehood to hoodwink the public into what the Consultancy Cadre in Pharmacy practice stands for.”Meanwhile, Chairman of NMA, Federal Capital Territory (FCT) Abuja chapter, Dr. Chiedozie Jude Achonwa, and the Scretary, Dr. Abdullahi Nasiru, in a statement, yesterday, said: “The NMA wishes to state clearly that the ongoing JOHESU strike is essentially against medical doctors in particular, and the peace-loving Nigerians in general. The unnecessary strike, we must let Nigerians know, is centered on quest for equal pay with Medical doctors as well as leadership (clinical governance) contestation in our hospitals.”

The NMA said the unwarranted leadership contest in the health sector by JOHESU in recent years has led to several untold hardships on patients with attendant avoidable loss of lives in some of public health institutions.Also, President PSN, Ahmed I. Yakasai, yesterday, commended the Nigerian Senate under the leadership of Dr. Abubakar Bukola Saraki for keeping to his promise on Basic Health Care Provision Fund.

Yakasai told journalists: “The PSN appreciates the provision of one per cent of the Consolidated Revenue Fund as Basic Health Care Fund in the allocation to the health sector in the 2018 Appropriation Act. This is surely a milestone, which will transform the health care landscape in Nigeria and invariably makes the Universal Health Coverage a reality.

“PSN commends the lawmakers for providing N57.15 billion in this year’s budget as provided by the National Health Act 2014 which was passed in 2014 but not fully implemented till date.“PSN believes that with this in focus, it should now be possible for every Nigerian to have a feel of health care services he or she needs, when and where without facing financial hardship, which is the goal the law intends to achieve. Also, by extension this will improve health, reduce poverty, create jobs, drive economic growth by healthy citizens and prevent epidemics.”

Meanwhile, the National chapter of the Association of Community Pharmacists of Nigeria (ACPN) has charged the federal government on the immediate closure of all open drug market in Nigeria and the full implementation of the National Drug Distribution Guidelines (NDDG).The body of pharmacists, who is reacting to the British Broadcasting Corporation (BBC) documentary on codeine and the federal government’s ban on codeine, decried government’s neglect to its prolonged call for action on the menace of open drug market and distribution chain in the country.

Speaking at a press briefing in Lagos, the National Chairman, ACPN, Dr Alkali Kelong lamented on the series of national conferences, held by the pharmacists to draw government’s attention and all regulatory agencies on the need to police the drug distribution chain, of which its negligence has given rise to the abuse of drugs and narcotic substances in Nigeria, especially cough syrups containing codeine and other controlled medicines.

He noted that unqualified professionals, charlatans, quacks and dubious individuals have taken advantage of the porous distribution system to carry out illicit trading in medicines that should be controlled by the pharmacists.

“The drug industry has been seen by some individuals as a money making venture, forgetting the fact that the aim of medicine use is to save lives and ensure that sick persons get the right doses to achieve a healthy outcome,” he said.

The pharmacist expressed fear on the consumption of Dextromethorphan, an antitussive cough medicine with sedative, dissociative and stimulant properties, at higher doses, found in many over-the-counter drugs, as addicts could turn to it as an alternative for codeine.Alkali said the present state of the country calls for a holistic approach in solving the issues of drug abuse, adding that a fire brigade approach should be avoided for total elimination.

He, however, charged the federal government to reactivate the national prescription policy, reconstitute the pharmacists council for effective regulation of pharmacy practice, free the streets from medicine hawkers, full implementation of the NDDG to ensure the stipulated deadline is met and the implementation of the new Pharmacy Act as well as policies on controlled medicines among others.

Addressing pharmaceutical practice in the country, the National chairman further said the association would not hesitate to take disciplinary actions against any member found wanting of the crime, calling on the federal and state governments to take drug matters seriously and to retain the exclusive legislative list.

The PSN added: “The PSN (Lagos State Branch) is concerned about the imperfect logic and the abundance of ignorance/mischief which the NMA Lagos Branch showcased as it continues in alignment with its parent body to ventilate invectives on pharmacy practice in Nigeria.

“The climax of the many absurdities of the NMA Lagos Branch was to insinuate that it is the duty of clinical pharmacologists to undertake pharmaceutical care. This is an erroneous assertion as clinical pharmacologists has no knowledge of pharmaceutical chemistry as it relates to pharmacokinetics, pharmacodynamics and drug delivery mechanisms, which are the exclusive preserve of a pharmacist. Often times we have admonished the NMA to run induction programmes for its array of ill – equipped representatives who are not even familiar with the ethics and philosophy of inter-professional relationship management preached by the World Medical Association.”

The NMA added: “Concerning the quest by JOHESU to earn equal pay with doctors, it must be reiterated that NMA has never been against any wage or salary increase or adjustment for health workers. Rather, NMA has, in her numerous engagements, severally advocated for wage or salary increase for all Nigerian workers.

“ It must be emphasized that what JOHESU is asking for is not necessarily increment in salary per se, but equal pay as doctors. They want government to pay them exactly the same amount as paid to doctors. Is a court clerk paid the same wage as a judge, or an air hostess as a pilot? The answer is definitely NO. It should be expected, therefore, that NMA will never allow JOHESU to use subterfuge and backdoor approach to become doctors. The universities are out there with clearly spelt-out guidelines for anyone who wishes to study Medicine and Dentistry. We wish to encourage JOHESU to take advantage of that rather than employing this back door approach to become ‘’doctors’.”

The doctors added: “It is our hope that government, while engaging in dialogue on these matters with a view to making progress, will not precipitate another crisis by bowing and acceding to pressure from JOHESU.“… We urge the allied health professionals to be reasonable in their demands, suspend their strike, return back to work to join the doctors to continue the good work for the benefit of the masses.”